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Updated: Nov 2, 2025
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Radiofrequency Ablation for Movement Disorders: Risk Factors for Intracerebral Hemorrhage, a Retrospective Analysis
Shiro Horisawa1, Atsushi Fukui1, Taku Nonaka1
1Department of Neurosurgery, Neurological Institute, TokyoWomen's Medical University, Tokyo, Japan.
Background:
One of the greatest concerns associated with radiofrequency ablation is intracerebral hemorrhage (ICH). However, the majority of previous studies have mainly evaluated Parkinson disease patients with ablation of the globus pallidus internus (GPi).
Objective:
To investigate the hemorrhagic risk associated with radiofrequency ablation using ventro-oral (Vo) nucleus, ventral intermediate (Vim) nucleus, GPi, and pallidothalamic tract.
Methods:
Radiofrequency ablations for movement disorders from 2012 to 2019 at our institution were retrospectively analyzed. Multivariate analyses were performed to evaluate associations between potential risk factors and ICH.
Results:
A total of 558 patients underwent 721 stereotactic radiofrequency ablations for movement disorders. Among 558 patients, 356 had dystonia, 111 had essential tremor, and 51 had Parkinson disease. Among 721 procedures, the stereotactic targets used in this study were as follows: Vo: 230; Vim: 199; GPi: 172; pallidothalamic tract: 102; Vim/Vo: 18. ICH occurred in 37 patients (5.1%, 33 with dystonia and 4 with essential tremor). Symptomatic ICH developed in 3 Vo nuclei (1.3%), 3 Vim nuclei (1.5%), and 2 GPi (1.2%). Hypertension (odds ratio = 2.69, P = .0013), higher number of lesions (odds ratio = 1.23, P = .0221), and younger age (odds ratio = 1.04, P = .0055) were significant risk factors for ICH associated with radiofrequency ablation.
Conclusion:
The present study revealed that younger age, higher number of lesions, and history of hypertension were independent risk factors for ICH associated with stereotactic radiofrequency ablation.
Insights
Radiofrequency ablation for movement disorders carries a risk of intracerebral hemorrhage (ICH). Younger age, hypertension, and multiple lesions are key risk factors for ICH during these procedures.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Intracerebral hemorrhage (ICH) is a significant concern in radiofrequency ablation (RFA).
- Previous research primarily focused on Parkinson disease patients undergoing globus pallidus internus (GPi) ablation.
Purpose of the Study:
- To assess the risk of ICH associated with RFA targeting the ventro-oral (Vo) nucleus, ventral intermediate (Vim) nucleus, GPi, and pallidothalamic tract.
- To identify independent risk factors for ICH in patients undergoing RFA for movement disorders.
Main Methods:
- Retrospective analysis of 721 RFA procedures for movement disorders (2012-2019).
- Multivariate analyses were conducted to determine associations between potential risk factors and ICH.
- Patient data included diagnoses (dystonia, essential tremor, Parkinson disease) and ablation targets.
Main Results:
- ICH occurred in 5.1% of patients (37/721), predominantly in those with dystonia.
- Symptomatic ICH rates were 1.3% for Vo, 1.5% for Vim, and 1.2% for GPi targets.
- Significant risk factors for ICH included hypertension (OR=2.69), a higher number of lesions (OR=1.23), and younger age (OR=1.04).
Conclusions:
- Younger age, a higher number of lesions, and a history of hypertension are independent risk factors for ICH following stereotactic RFA.
- These findings highlight specific patient and procedural characteristics associated with increased hemorrhagic risk.
